To think Physician Associates are (mostly) a false economy?

Completely agree on scope of practice. I think until that can be fully determined, the push for the GMC to regulate these non-doctors should be halted. PAs have already been involved in some incidents that led to serious injury or death due to missing things and misdiagnosis. An overworked GP could also do this, of course. But they've at least had the required years of training to enable them to work in a complex, multidisciplinary area of medicine in the community.

My surgery has one and they said on the phone she was a doctor - she then had to explain she wasn't when I asked. Fair enough if you want to use one as triage for minor ailments, but at least tell patients.

I think the issue here is scope of practice, and one I do agree is a safety issue with regard to PA's (I work with them regularly as part of a team).

We all have times when we're not sure, need to ask etc even with tonnes of experience.....however here the PA cannot order investigations and therefore shouldn't have stated that was part of the management plan when technically they need to discuss a management plan with their supervising GP - as PP said they are dependant practitioners.
With issues where cancer is a possibility, referring into diagnostic pathways such as breast clinic etc I think this is outside this person's scope and therefore they could/should have just got the GP to pop in while you were at the surgery. Or this shouldn't have been our on their appointment list in the first place.

Unfortunately what seems to be happening is surgeries are happy for PA's to act as a kind of triage system seeing anything and everything even if their scope of practice and/or experience doesn't reflect this and then discuss with a GP - your case is a key example of how this is distressing for the patient, puts the PA in a difficult position, wastes time and resources etc. PA's have a place in the team however they are certainly not 'mini doctor's.

This is not a great experience but as someone who works in a hospital I just want to address a few things. The jobs are not “beneath nurses” it’s just that nurses are doing all the other jobs that HCAs are not qualified to do, such as giving medication and carryin out specialist procedures. The “three nurses chatting” was more than likely them talking about patients or giving nursing handover i.e. exactly the thing you are asking of them to do - communicating about patients to each other and other staff members. It’s true that a good HCA is worth their weight in gold and are in short supply. Gven staff shortages, I highly doubt nurses had nothing to do…
As far as not being seen by the right professional at the GP surgery, it happened to me once and it wasn’t great. Consequently, I see many people complain about receptionists at the GP surgeries “interrogating” the callers about the reason for an appointment. Well…. this is done exactly so that you are booked in with the right person.

That sounds horrendous Lulu

just on your first point, there is no actual shortage of doctors. There is a shortage of funded posts of doctors in the NHS. Literally thousands of doctors have not gotten training posts because the government chooses to fund non- doctors such as physician assistants. Even while the public want to see a GP, they turn away thousands of doctors who want to train to be GPs.

This is an active choice by the government

It is accepting people who have watered down medical skills because there are not enough GPs/dentists whatever.

There are so many staff below the level of nurses doing jobs nurses once did and now consider beneath them that it's hard to know who/what they are. I posted last week about the experiences of my 90+ year old aunt in Cramlington A and E.

Her 'obs' were being taken by someone who wore a nurses-type uniform but who was not a nurse. She missed that the arm which she had measured her blood pressure on 5 x (because it was high) was also the arm filling up with fluid from the IV because the drip had torn the blood vessel. There was a balloon of fluid filled skin the size of an orange, like a giant blister. When I pointed it out she did not know what to do so called a nurse. She told the nurse she had taken my aunt's blood-pressure 5 x on that arm and not noticed and the nurse said 'It doesn't matter.'

The next day I asked a nurse about my aunt's weight and whether she could have a shower- as she was too weak to even sit up in bed and had not been showered for over a week or had her teeth cleaned. She said she did not know the answer to either question and got someone who, again, looked like a nurse but wasn't. That person was one of two washing, showering, cleaning, changing patients while thenurses chatted in the 'reception hub'. She suggested my aunt got out of bed and went into the bathroom to clean her own teeth- I had to say 'She can't walk or even sit up.'

It was as if the nurses felt those 'care' jobs were beneath them even when they had nothing else to do. They don't even seem to share info beteween the different staff.

It will become the same with Drs and things will be missed. The NHS is fucked.

So is adult social care. My aunt has a social worker who was 'on leave' from 22nd Dec until 8th January. She is now 'on leave' again from 30th January until 12th Feb'. She managed to see my aunt once in that gap between 8th-30th January. Couldn't see her from mid-Nov until 22nd Dec as 'too busy'. No one else will deal with her case.

Meanwhile my aunt is stuck in a care home paying :
£1300 a week (£5200 a month)for care there,
£800 a month rent for her sheltered housing type accommodation ,
plus £760 a month for additional care at her sheltered housing type accommodation,
plus has paid £700 to have a stairlift installed which she can not use as it is too cumbersome and heavy for her and an ongoing rental fee for the equipment which she can't use.

£7000 a month wasted money on unused/unnecessary care and none of it can be cancelled because we don't know where she is going to be able to live and the social worker is not at work long enough to make something actually happen or meet with us to give us timescales/possibilities.
So far she has been there 10 weeks - it's £20,000 of wasted money so far. Money she will need for her future care.

I was told today she will have to pay 4 weeks notice for the care and rent at her sheltered type house when it is cancelled- another £1500 of her money wasted.

I have never heard of this role before but it sounds like a waste of time and money.

I am not adverse to different types of roles at GP surgeries. We have a nurse practitioner and a pharmacist at our GP surgery who are great in their respective roles. Eg the pharmacist does asthma reviews and is available to talk about medication concerns but this sounds pointless.

Physican associates are a complete false economy. No idea where you have these numbers from, because they are so very wrong. Physician associates are paid Band 7, it is centrally funded ( by our taxes) to encourage GP practices to take them on at no cost to the practice.

The whole role is being misused in the NHS- they are dependent practitioners who must be supervised- so unlike a Gp, and not in any way like a doctor seeking a second opinion.

If they want to work as doctors, they should just train as doctors. That’s surely the answer if we want appropriate healthcare for the public.

But that’s not what the tories want.

I would insist on seeing a doctor

It worries me. An USS, in this context, should only be done as part of a properly constituted breast clinic. Your GP clearly wants to find out if you have enough indication to refer to one. Which is commonly done on the first visit (though occasionally on a second).

This worries me. What with pharmacists and physician's associates, I'm terrified for the health of the nation.

Maybe the GP would have wanted to see you twice before referring for a scan?

Did the PA know in advance what you'd be asking about?

Even GPs ask for second opinions - many of them have particular interests/specialties and their colleagues may seek a second opinion from them.

A physician associate appointment is estimated to cost £7. A GP appointment is estimated to cost £36. So two physician associate appointments is less than half the cost of one GP appointment.

A PA would still need a second opinion on UTIs, skin diseases because they are not currently allowed to prescribe.